Accreditation
SINTA 2Nationally Accredited Journal
Vol. 10 No. 11 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Preterm Birth and Other Adverse Pregnancy Outcomes in Women With Chronic Kidney Disease: A Systematic Review with Exploratory Meta-Analyses in Lupus and Diabetic Nephropathy
Views: 145Downloads: 90Background: Chronic kidney disease complicates interpretation of pregnancy risk because exposure definitions, denominators, underlying diseases, and clinical practices vary. This review evaluates associations with preterm birth and other adverse pregnancy outcomes while preserving these distinctions.
Objective: To evaluate associations between pre-existing chronic kidney disease and preterm live birth and other adverse maternal and neonatal outcomes, and to determine which disease-specific estimates could be combined without conflating populations, outcome definitions, or crude and adjusted effects.
Methods: PubMed and Europe PMC were searched with supplementary renal disease and microalbuminuria searches. Comparative observational studies were assessed using a prespecified protocol registered as CRD420261503668. Extraction distinguished established CKD, reduced kidney function, and disease-matched comparisons. Exploratory sensitivity analyses used crude risk ratios, restricted maximum likelihood, and modified Hartung–Knapp intervals.
Results: Thirty-four reports were mapped; eight contributed to three disease-matched crude analyses. The prespecified adjusted primary CKD estimate could not be pooled. Pooled risk ratios were 1.12 (95% confidence interval 0.13–9.35) for lupus-nephritis preterm birth, 2.79 (0.84–9.25) for lupus-nephritis preeclampsia, and 1.35 (1.21–1.51) for diabetic-nephropathy cesarean delivery. Adding a quiescent-nephritis cohort yielded a preterm-birth ratio of 1.24 (0.39–3.97). One cohort contributed 92.1% of the cesarean-analysis weight. Certainty was very low.
Conclusion: Diabetic nephropathy was associated with higher crude cesarean-delivery risk, whereas lupus-nephritis estimates remained highly imprecise. Confounding, repeated pregnancies, and restricted evidence availability limit clinical inference.
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Neglected Open-Globe Injury and Limb Amputation Following a Blast Explosion in a Pediatric Polytrauma Patient: An Observational Analytic Case Study on Delayed Ophthalmic Intervention, Ocular Trauma Score Dynamics, and Health System Barriers in Remote Eastern Indonesia
Views: 96Downloads: 78Background: Blast-related ocular trauma in children in archipelagic developing regions is a devastating, multimechanistic emergency, often complicated by systemic polytrauma prioritization and geographical referral barriers.
Objective: To characterize the clinical trajectory, Ocular Trauma Score dynamics, and health-system barriers of a neglected pediatric open-globe blast injury with concomitant traumatic hand amputation in remote eastern Indonesia.
Methods: A 13-year-old boy presented 5 days after a homemade fish-bomb explosion. Evaluation used Birmingham Eye Trauma Terminology (BETT) classification, longitudinal biomicroscopy, acoustic B-scan ultrasonography, quantitative Ocular Trauma Score (OTS) and modified Pediatric OTS, and multi-level structural barrier assessment.
Results: At presentation (Day 5), right eye (OD) visual acuity was light perception with intraocular pressure of 7 mmHg, full-thickness superior eyelid margin laceration, total dark hyphema (Grade IV), and traumatic corneal scars, while the left eye (OS) maintained 20/20 vision with multiple corneal foreign bodies. Acoustic B-scan OD revealed complete funnel-shaped retinal detachment tethered to the optic disc and dense vitreous hemorrhage. OD calculated an OTS raw score of 12 (Category 1, 74% no-light-perception probability). Following surgical delays driven by maritime transit and BPJS insurance administrative bottlenecks, 1-week follow-up (Day 12) revealed fulminant corneal keratolysis with diffuse stromal melting, chemosis, and cicatricial eyelid notch, whereas OS achieved complete corneal re-epithelialization.
Conclusion: Neglected pediatric blast ocular trauma leads to accelerated enzymatic keratolysis and irreversible functional amaurosis when systemic polytrauma prioritizes limb salvage over sight. Integrating mandatory ophthalmic triage into rural disaster protocols is critical.
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Ocular Tuberculosis in Advanced Proliferative Diabetic Retinopathy: A Diagnostic and Therapeutic Dilemma in A Vitrectomized Eye
Views: 88Downloads: 63Background: Ocular tuberculosis (OTB) is a paucibacillary extrapulmonary infection, hard to recognize in an eye compromised by proliferative diabetic retinopathy (PDR) and vitreoretinal surgery, where postoperative inflammation, tamponade artifacts, hemorrhage and diabetic microangiopathy mimic infectious uveitis.
Objective: To characterize the diagnosis, molecular confirmation, and longitudinal outcomes of occult ocular tuberculosis in a vitrectomized eye with end-stage proliferative diabetic retinopathy.
Methods: A 50-year-old man with type 2 diabetes and pulmonary tuberculosis presented with acute inflammation (OD) 5 days after pars plana vitrectomy. He was followed over six milestones (T0–T5, 16 weeks) with SD-OCT and vitreous nested RT-PCR (IS6110/MPB64); outcomes were best-corrected acuity (LogMAR), intraocular pressure and central macular thickness (CMT).
Results: At T0 (OD 1/300, LogMAR 2.48) with ciliary flush and gas endotamponade, vitreous RT-PCR was positive for M. tuberculosis DNA (IS6110/MPB64), establishing intraocular tuberculosis masked by surgical inflammation. Quadruple antituberculous therapy (RHZE) with corticosteroids improved vision to 6/30 (LogMAR 0.70) by week 3 and 6/21 (LogMAR 0.54) by week 6. At week 7, SD-OCT unmasked diabetic cystoid macular edema (CMT 365 µm) that responded to sub-Tenon triamcinolone (CMT 340 µm), with final acuity 6/9.5 corrected (LogMAR 0.20) at week 16. The contralateral eye (OS) developed neovascular glaucoma (IOP 51.0–63.0 mmHg) and no light perception, requiring silicone oil evacuation.
Conclusion: Ocular tuberculosis must be suspected in atypical intraocular inflammation in vitrectomized eyes, especially with tuberculosis or diabetes. Vitreous PCR is decisive when signs overlap with surgical trauma and diabetic microangiopathy, and prompt antituberculous plus corticosteroid therapy can achieve visual salvage.
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Prenatal Identification, Transitional Hemodynamic Remodeling, and Multidisciplinary Management of Ebstein's Anomaly with Coexistent Urogenital Malformations: An Observational Analytic Case Study
Views: 87Downloads: 81Background: Ebstein’s anomaly is an uncommon congenital heart defect with failed tricuspid delamination, right-ventricular atrialization, and severe regurgitation. Prenatal detection is difficult on routine obstetric ultrasonography, and perinatal hemodynamic transition carries substantial mortality.
Objective: To document the prenatal identification, transitional neonatal hemodynamic remodeling, and multidisciplinary management of Ebstein’s anomaly with coexistent urogenital malformation.
Methods: A 28-year-old multigravida referred at 34–36 weeks with a suspected cardiac anomaly was followed through multidisciplinary re-evaluation, term cesarean delivery, neonatal intensive care, and 3-month follow-up, with serial hemodynamic profiling and risk stratification.
Results: Initial referral ultrasound suspected double outlet right ventricle, which was revised to Ebstein’s anomaly (Carpentier Type B) with dilated pulmonary trunk and coexistent bilateral testicular hydrocele and hypospadias upon joint fetomaternal-pediatric cardiology assessment. Delivery at 38–39 weeks yielded a male neonate (3,050 g, Apgar 5/7, SpO2 85%). Postnatal echocardiography confirmed Ebstein’s anomaly with moderate-to-severe tricuspid regurgitation (peak pressure gradient 78 mmHg), a 3–4 mm atrial septal defect with right-to-left shunting, and a 3 mm patent ductus arteriosus with left-to-right shunting. Conservative medical stabilization utilizing non-invasive continuous positive airway pressure, oral captopril, and furosemide averted emergency neonatal cardiac surgery. At 3 months, serial echocardiography revealed spontaneous ductal closure, reduction of tricuspid pressure gradient to 21 mmHg (Δ% = -73.1%), shunt reversal to left-to-right, and complete hydrocele resolution.
Conclusion: Late third-trimester diagnostic conversion highlights the need for structured fetal echocardiography beyond four-chamber views. Favorable outcomes in severe Ebstein’s anomaly are achievable through coordinated multidisciplinary care, where falling pulmonary vascular resistance drives non-operative hemodynamic remodeling.
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Comparative Profiling of Arterial Stiffness and Radiocephalic Arteriovenous Fistula Morphology in Diabetic Versus Non-Diabetic Patients on Maintenance Hemodialysis
Views: 71Downloads: 63Background: Diabetes mellitus accelerates cardiovascular deterioration in chronic kidney disease, but it is unclear whether it adds stiffness to the central arteries or affects the peripheral arteriovenous fistula (AVF) of hemodialysis patients.
Objective: To compare central and peripheral pulse wave velocity (cfPWV, faPWV), renal resistive index (RI), and radiocephalic AVF diameter and volume flow between diabetic and non-diabetic hemodialysis patients.
Methods: This analytical cross-sectional study included 120 prevalent hemodialysis patients (22 diabetic, 98 non-diabetic) at Dr. M. Djamil General Hospital in 2025. One blinded sonographer measured the vascular parameters by Doppler ultrasonography. Groups were compared with t-tests and chi-square tests, with 95% confidence intervals and Cohen's d.
Results: Diabetic patients were older (56.4 ± 8.1 vs. 50.6 ± 9.4 years; p = 0.004) and had lower diastolic blood pressure (73.27 ± 9.84 vs. 79.72 ± 10.15 mmHg; p = 0.008). cfPWV (2.89 ± 0.57 vs. 2.90 ± 0.61 m/s; p = 0.941), faPWV (3.34 ± 0.73 vs. 3.15 ± 0.69 m/s; p = 0.236), and mean RI (0.825 ± 0.029 vs. 0.818 ± 0.033; p = 0.341) did not differ. AVF diameter was smaller in diabetic patients (1.74 ± 0.63 vs. 2.36 ± 0.74 mm; p < 0.001; Cohen's d = −0.86), whereas flow did not differ significantly (3489 ± 1018 vs. 3063 ± 945 mL/min; p = 0.072).
Conclusion: Diabetes was associated with a smaller AVF diameter but not with higher central or peripheral stiffness or renal RI. Given the cross-sectional, unadjusted design, adjusted longitudinal studies are needed.
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Immunohistochemical Subtype Conversion and Pathological Response After Neoadjuvant Chemotherapy in Luminal B HER2-Negative Locally Advanced Breast Cancer: A Cross-Sectional Study
Views: 75Downloads: 38Background: Luminal B HER2-negative breast cancer responds only modestly to neoadjuvant chemotherapy (NAC), and the receptor profile of its residual tumor may differ from that of the original biopsy.
Objective: To test whether subtype conversion after NAC is associated with pathological response.
Methods: This retrospective cross-sectional study included 49 consecutive women with stage IIIA–IIIB Luminal B HER2-negative cancer who received doxorubicin–cyclophosphamide or docetaxel–cyclophosphamide before mastectomy at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia (2024–2025). Conversion meant any change in immunohistochemical surrogate subtype between core biopsy and mastectomy. The outcomes were the Miller–Payne grade (primary) and the Residual Cancer Burden (RCB) class. Exact tests, proportional-odds and Firth logistic regression, and Holm correction were applied.
Results: Conversion occurred in 14 patients (28.6%; 95% CI 17.8–42.4), most often to Luminal B HER2-positive. Converted tumors had lower Miller–Payne grades (exact p = 0.027). None reached grade 4–5 (0/14 vs 9/35; p = 0.045). The adjusted cumulative odds ratio was 0.27 (95% CI 0.08–0.91). RCB-III was more frequent after conversion (78.6% vs 31.4%; adjusted OR 6.54, 95% CI 1.69–31.63). The association between conversion and the RCB class was the only one surviving Holm correction (p = 0.019), and the RCB-III association depended largely on eight HER2 gains defined by immunohistochemistry alone.
Conclusion: More than one in four Luminal B HER2-negative tumors changed surrogate subtype after NAC. Conversion, mostly HER2 gain, marked heavier residual disease. Before adjuvant therapy is chosen, receptors should be re-tested on residual tumor, with in situ hybridization to confirm HER2.
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Adult Immunogenicity and Descriptive Safety of TAK-003 Dengue Vaccination: A Systematic Review and Meta-analysis
Views: 40Downloads: 19Background: Adult TAK-003 data differ by formulation, baseline dengue status, coadministration, and outcome definition.
Objective: To synthesize adult immunogenicity and safety of the licensed two-dose final formulation of TAK-003.
Methods: We searched PubMed, Scopus, CENTRAL-derived records, registries, regulatory sources, and citations to the final search update. Screening, extraction, appraisal, and analysis used a reproducible computational workflow without independent duplicate verification. Seropositivity and 270-day serious adverse event (SAE) risk were modeled with binomial-normal logit models; comparative reactogenicity used random-effects risk ratios with modified Hartung-Knapp intervals. Certainty was graded by outcome, and a sensitivity analysis added the single-arm DEN307 cohort.
Results: Of 1,090 records, 606 unique records (553 publications and 53 registry records) were screened; 473 publications were excluded and 80 were retrieved. Five trials supplied quantitative outcomes. Among 620 baseline-seronegative adults, pooled seropositivity about 30 days after dose 2 was 98.7% for DENV-1 (95% CI 95.8–99.6), 99.0% for DENV-2 (97.9–99.6), 96.9% for DENV-3 (95.2–98.0), and 98.4% for DENV-4 (97.0–99.1). With DEN307 added, estimates were 98.8%, 99.2%, 97.1%, and 98.5% (752 participants per serotype). Across four cohorts, 29/1,468 participants had an SAE through day 270 (pooled risk 2.0%, 95% CI 1.4–2.8). Pain and headache estimates, each from two studies, were highly imprecise.
Conclusion: Final-formulation TAK-003 gave high short-term seropositivity in selected adult trial populations. The SAE risk was uncontrolled and does not establish comparative safety. Certainty was low or very low, and inference is limited by study size, surrogate outcomes, and uncontrolled safety data.
